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How to... Ensure good teamwork in the practice

Most practices will have GPs, nurses and reception and management staff in loose groupings. In order to increase the performance of these groups the GP partners need to ensure good teamwork.

This is how you do it

1 Have a recognised team-leader with clear responsibilities. He or she will usually be a GP, nurse or manager. It will be their responsibility to facilitate team meetings. Typical roles they will take on will include organising rotas and daily timetables and appraising team members.

2 Have weekly team meetings. Even if they last only 15 minutes they help build a team identity and remind everyone what the team objectives are. For example, the main objective of the reception team may be to answer the telephone within four rings. It's helpful to involve team members in setting their objectives.

3 Ensure each team is prepared to innovate. For example, the practice nurse team may be encouraged to look at skill mix and new ways of delivering care to carry out tasks done by doctors. This might involve them training additional health care assistants to take on routine CHD, diabetes, COPD and asthma care, leaving the practice nurses to develop triage and more complex chronic care previously seen by the GP.

4 Ensure each team member can do more than one task. This contributes a lot to teamwork and flexibility, and means that if a staff member is absent or leaves the practice the skills are not lost.

5 Have facilitators and coaches rather than managers to help people with new tasks. The traditional practice manager role, 'telling' people how to do things, does not allow personal development and the learning of new skills. The most effective way to train a member of staff is in the practice – not in the lecture theatre – just before they start the new task.

6 Encourage flexibility. This should be an

essential quality in the job specification of all practice staff. Existing staff may require training and support to learn these skills. It is especially important to be flexible when it comes to communication, conflict resolution, decision-making and problem solving.

7 Give everyone information on quality points, access, patient survey and other performance parameters.

GP partners should give staff information on practice performance, so they can see how they and their teams are performing. This knowledge can be a powerful tool in motivating staff. The information should be fed into the staff appraisal process when setting individual objectives.

Dr Sohail Butt is a GP in Ashford, Middlesex

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